Provider Demographics
NPI:1902304306
Name:DML DENTAL SERVICES LLC
Entity Type:Organization
Organization Name:DML DENTAL SERVICES LLC
Other - Org Name:DML COSMETIC DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:DELIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LOYOLA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:787-230-7573
Mailing Address - Street 1:544 CALLE ALDEBARAN STE 102
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00920-4227
Mailing Address - Country:US
Mailing Address - Phone:787-230-7573
Mailing Address - Fax:
Practice Address - Street 1:544 ALDEBARAN STREET, URB. ALTAMIRA
Practice Address - Street 2:EDIF. EDGEWELL, OFIC. 102
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00920
Practice Address - Country:US
Practice Address - Phone:787-230-7573
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-31
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3207261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental